Active NPI
Stephany Rae Luellen
- Massage Therapist
- Carlsbad, CA
National Provider Identifier
1538775564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 74367
- Practice address
- 421 Tamarack Ave # 2
Carlsbad, CA 92008-4128 - Phone
- (808) 212-6218
- NPI assigned
- Sep 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 74367 | CA | Primary |
Addresses
Primary practice location
421 Tamarack Ave # 2
Carlsbad, CA 92008-4128
Mailing address
PO Box 4342
Carlsbad, CA 92018-4342
Phone (808) 212-6218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74367 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1538775564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4342",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920184342",
"telephone_number": "808-212-6218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 TAMARACK AVE # 2",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920084128",
"telephone_number": "808-212-6218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUELLEN",
"first_name": "STEPHANY",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-16",
"last_updated": "2020-09-16",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "74367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.